why motivational interviewing · resources – rosengren, d.b. (2009). building motivational...

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WHY MOTIVATIONAL INTERVIEWING ? Stephanie A. Ballasiotes, MC. Two Steps Forward Training and Consulting www.2sft.com

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Page 1: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

WHY MOTIVATIONALINTERVIEWING?

Stephanie A. Ballasiotes, MC.Two Steps Forward Training and Consulting

www.2sft.com

Page 2: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

What do you know aboutMotivational Interviewing?

Page 3: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Let’s begin with some thoughts from someone who worked to find his place…

Finding Strengths

place…

Page 4: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

What is MI?

a collaborative, goal-oriented style of communication with particular attention given to the language of change. communication with particular attention given to the language of change.

Page 5: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

What is MI?

designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.

Page 6: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Let’s imagine for a moment…

• You’re stuck on the horns of a personal real dilemma

• You’ve tried to reason your way through it• You’ve tried to reason your way through it

• Friends are not an option

• You need discretion

• What qualities do you want for a helper?

Page 7: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

• Pair up

• Share qualities with partner

• Listener: NO TALKING, NO QUESTIONS• Listener: NO TALKING, NO QUESTIONS

Page 8: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Two Elements:• The relationship

– “Spirit” of MI

Lets break it down a bit

• Technical– Skills: Client centered– Strategies

Page 9: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

MI Spirit

Partnership

Acceptance

Compassion

Evocation

Page 10: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Five fundamental skills…

• Open Questions

• Affirmations

• Reflections

• Summaries• Summaries

• Information sharing/exchange

Not unique to MI…..right?

Page 11: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Which brings us to Darryl Bem and Self-Perception Theory…

• In situations where we’re not sure what we believe

Why is Listening So Important?

we believe

• We come to believe what we hear ourselves say

• Except when coerced

Page 12: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Break down a bit more….

• What’s up withambivalence?

– Two sides, reasons for/against, – Two sides, reasons for/against, – Up and down– Wants answer, but doesn’t – Normal

Page 13: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Change and Sustain Talk

Page 14: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

And pushing on ambivalence creates…?

Page 15: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Break down a bit more….

• What is change talk?– I want, need, should, can– I’m worried, don’t want, – reasons to– reasons to

What video and write downchange talk

Page 16: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

What does it look like…

Page 17: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Giving Advice

How much of you work involves giving information or advice?How much should you give?HOW do you give it? What happens when we give unsolicited advice?

Page 18: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

ADVICE?

Page 19: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Doctor - Patient

Page 20: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Righting Reflex

• Born of concern and caring

• There’s a problem? Let’s fix it!• There’s a problem? Let’s fix it!

• Fails to consider ambivalence in change process

• May engender resistance

Page 21: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

What could this look like?

OARS

• Collaborative• Goal-oriented (whose goal?)

• Attention to the language of change • Eliciting and exploring client’s reasons for change

• Accepting• Compassionate

Page 22: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

In a Framework of:

Four Fundamental

Processes …Evoking

Planning

Engaging

Focusing

Page 23: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Exercise – BranchingScripts

Page 24: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

WHAT ARE YOUR REASONS TO GIVE IT A TRY?

Miller & Rollnick, 2012

Page 25: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

MI is powerful,

but like a muscle, it must be built.

Page 26: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

End with a little inspiration!

Page 27: WHY MOTIVATIONAL INTERVIEWING · Resources – Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Press. – Arkowitz,

Resources

– Rosengren, D.B. (2009). Building Motivational Interviewing Skills: A Practitioner’s Workbook. New York: Guilford Skills: A Practitioner’s Workbook. New York: Guilford Press.

– Arkowitz, H. Westra, H. Miller, W.R., & Rollnick, S. (2008). Motivational Interviewing in the Treatment of Psychological Problems. Guilford: New York.

– Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. Guilford: New York.

– Training Tapes: MI Series– MI Website: www.motivationalinterviewing.org